This weeks #Otalk is on the topic of Fire safety and will be hosted by David Marsden (@D_MARSDEN_OT).

Here is what David had to say…

There is a decreasing trend in fire incidents and injuries as result of successful fire safety and prevention activity. However, the rate at which this figure is reducing has slowed down it is thought because of a small group of people known by fire services as ‘people at increased risk of fire’ (PaIRoFs). The journey started in 2007 when I met with a community safety manager form Greater Manchester Fire and Rescue Service because they had a feeling that people with mental health conditions were more likely to die in fires than others ie PaIRoFs. We compared the fire deaths between 201-2007 with Trust records and found that 37% of those who died in fires were known to mental health services in Manchester.

As a result of this we felt we had to act and agreed a formal partnership and a jointly funded post between GMFRS and what was Manchester Mental Health and Social Care Trust (Now Greater Manchester Mental Health NHS Foundation Trust (GMMH)). We recruited an occupational therapist for 2 years consider help the fire service to think beyond the environmental cause of fire and look at the interrelationships between the person, the things they do day-to-day (occupation) and their physical and social environment with regard to fire risk and safety.

In 2011, the University of Salford were commissioned to independently evaluate the pilot project. It was noted by the author that the project was a ‘successful collaboration’ and that the ‘investment to save potential for this specialist partnership are clearly measured’. GMMH and GMFRS decided that a sustainable approach was required to maintain these outcomes and that any future approach should acknowledge that in general physical and mental health issues contributed to fire risk, not mental health issues alone. Rather than one occupational therapist bridging the organisations we moved to training all occupational therapists in the Trust to carry out specialist occupational assessments in collaboration with the fire service staff. This was cemented in our partnership agreement.

At this point GMFRS took the positive step of recruiting a health and social care coordinator to foster similar partnerships across Greater Manchester. This happened to be Paula Breeze who was the occupational therapist employed in the pilot. In 2015 Paula and I published guidance for other health and social care providers. The aim was to spread good practice to help reduce injury and death from fire in PaIRoF groups. Key objectives included: setting up sustainable partnerships, collaboration in assessments and interventions and skill sharing.

One components of this guidance was an example of how, in Manchester, we strengthened the partnership through the use of occupational therapy and occupational therapy non-traditional/role emerging placements. A key focus of the fire and rescue service currently is delivering safe and well checks which are an expansion of the old safety checks or home fire risk assessments you may be familiar with. So when fire and rescue staff go to people homes they now ask about health and wellbeing and signpost where necessary. This is clearly more holistic and requires a person centred approach to engage individuals who may have a health condition or disability. Occupational therapists are best placed to assist the fire and rescue service in achieving this aim. In our experience fire and rescue service staff have responded well to our description of fire risk in terms of occupational therapy models. For example, looking at the person, their occupations and the environment and the interrelationship between these. Fire services don’t traditionally employ occupational therapists so role emerging placements has been an ideal way to support the fire and rescue service aims whilst exposing them to the added value of the profession.

With the aim of sustaining our efforts nationally and spreading partnership work across the UK I recently developed a plan in collaboration with and with the support of the Lead Allied Health Professional and National Engagement Lead for Police and Fire Services at Public Health England, the Chief Fire Officers Association, NHS England and the College of Occupational Therapists. The plan includes developing a national network, national repository for information and a webinar series to share best practice/collaborate. Going forward there’s an aspiration to collaborate further and carry out research.